@layout("/common/_form.html",{js:["/assets/modular/system/btyZxBaoxiaodan/btyZxBaoxiaodan_add.js"],css:["/assets/expand/module/formSelects/formSelects-v4.css"]}){

<form class="layui-form" id="btyZxBaoxiaodanForm" lay-filter="btyZxBaoxiaodanForm" onsubmit="return false">
    <div class="layui-fluid" style="padding-bottom: 75px;">
        <div class="layui-card">
            <div class="layui-card-header">基本信息</div>
            <div class="layui-card-body">
                <div class="layui-form-item layui-row">
                    <input name="id" type="hidden"/>

                    <div class="layui-inline layui-col-md12">
                        <label class="layui-form-label">店名<span style="color: red;">*</span></label>
                        <div class="layui-input-block">
                            <select id="shopName" name="shopName" lay-verify="required" required lay-search>
                                <option value="">请选择门店</option>
                            </select>
                        </div>
                    </div>

                    <div class="layui-inline layui-col-md12">
                        <label class="layui-form-label">报销金额<span style="color: red;">*</span></label>
                        <div class="layui-input-block">
                            <input id="reimbursementAmount" onkeyup="value=value.replace(/^\D*(\d*(?:\.\d{0,2})?).*$/g, '$1')" autocomplete="off" name="reimbursementAmount" placeholder="请输入报销金额" type="text" class="layui-input" lay-verify="required" required/>
                        </div>
                    </div>

                    <div class="layui-inline layui-col-md12">
                        <label class="layui-form-label">统称备注<span style="color: red;">*</span></label>
                        <div class="layui-input-block" style="display: flex;">
                            <div>
                                <input style="width: 270px;" id="productRemark" autocomplete="off" name="productRemark" placeholder="请输入货品统称备注" type="text" class="layui-input" lay-verify="required" required/>
                            </div>
                            <div class="layui-upload" style="width: 50px;display: inline">
                                <input type="hidden" name="fileUrl" id="fileUrl">
                                <button type="button" class="layui-btn layui-btn-primary layui-border-blue" id="upload" style="margin-left: 10px;">导入货品单</button>
                            </div>
                        </div>
                    </div>

                </div>
            </div>
        </div>
    </div>
    <div class="form-group-bottom text-center">
        <button class="layui-btn" lay-filter="btnSave" lay-submit id="btnSave">仅保存不提交审核</button>
        <button class="layui-btn" lay-filter="btnSubmit" lay-submit id="btnSubmit">提交审核</button>
    </div>

</form>

@}